Vitrectomy

by Michael Jubinville, MPH

Definition

A vitrectomy is the removal of a gel-like fluid from the center of the eye called the vitreous humor. This fluid gives the eyeball its shape and plays an important role in vision.

Normal Anatomy of the Eye

Reasons for Procedure

A vitrectomy may be done:

To remove blood or other debris that is making the vitreous humor cloudy and blurring vision
To allow the doctor to access the rear wall of the eye during surgery
To improve healing of other damaged areas of the eye

Conditions that may lead to need for vitrectomy include:

Vitreous hemorrhage—blood leaking into the vitreous humor
Retinal tear or detachment, macular problems, or complications from diabetic retinopathy
Eye trauma or infection

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Development of cataracts
Infection
Retinal tear or detachment
Damage to other eye structures, such as the lens or cornea
Scar tissue
Increased pressure inside of the eye
Vision problems
Additional procedures

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

Smoking
Drinking
Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

Your doctor will give you a physical exam, including a thorough evaluation of the eye. Blood tests or an ultrasound may be done.

Talk to your doctor if you take any medications, herbs, or supplements. You may need to stop taking medications up to 1 week before the procedure.
Arrange for a ride home.

Anesthesia

Local anesthesia is used to numb the eye and surrounding area.

Description of the Procedure

Tiny incisions are made in the whites of the eyes. A small instrument is inserted through the incisions to remove the vitreous humor and any debris. The doctor will then be able to access other areas of the eye to complete any additional repairs.

When the procedure is complete, a gas bubble, saline solution, or silicone oil will be injected in the eye to take the place of the vitreous humor. The replacement will help the eye maintain its shape.

How Long Will It Take?

The length of the procedure will depend on other work that needs to be done. A vitrectomy itself takes about an hour.

Will It Hurt?

Anesthesia will block pain during the procedure. Discomfort after the procedure can be managed with medications.

Post-procedure Care

At the Care Center

Right after the procedure, the staff may:

Place an eye patch or shield over the affected eye
Give medications or eye drops to reduce discomfort

You will be able to leave when you are alert and well enough to travel home.

At Home

Eyesight may be affected for a time as your eye heals.

Certain activities will need to be limited to avoid excess pressure on the eye like strenuous exercise or heavy lifting. Air travel may also be limited if a gas was used to fill the eye.

The eye will eventually refill the eye with vitreous humor. If gas was used, the gas bubble will eventually dissolve on its own as the vitreous humor moves in. If oil was used, it will need to be removed with another procedure.

Call Your Doctor

Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:

Signs of infection, including fever and chills
Worsening vision problems, such as blurring, cloudiness, or black spots
Pain that does not go away with the medications you were given
New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right way.

RESOURCES:

Eye Smart—American Academy of Ophthalmology
http://www.geteyesmart.org

National Eye Institute (NEI)
https://nei.nih.gov

CANADIAN RESOURCES:

Canadian Association of Optometrists
https://opto.ca

Canadian Ophthalmological Society
http://www.cos-sco.ca

References:

Kim DY, Joe SG, et al. Acute-onset vitreous hemorrhage of unknown origin before vitrectomy: Causes and prognosis. J Ophthalmol. 2015. [Epub ahead of print].

Reeves SW, Kim T. How to perform an anterior vitrectomy. American Academy of Ophthalmology website. Available at:
...(Click grey area to select URL)
Accessed November 23, 2015.

Vitrectomy. Eye Institute website. Available at:
...(Click grey area to select URL)
Accessed November 23, 2015.

Vitrectomy surgery. Casey Eye Institute website. Available at:
...(Click grey area to select URL)
Accessed November 23, 2015.

Warrier SK, Jain R, et al. Sutureless vitrectomy. Indian J Ophthalmol. 2008;56(6):453-458.

Last reviewed May 2018 by Michael Woods, MD
Last Updated: 03/07/2016

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